Q: I’m 69 years old. I have never had chickenpox. Should I get vaccinated against shingles? I can’t get a straight answer from my doctor, nor can I find a straight answer on the web. The JAMA says shingles results from a reactivation of the chickenpox virus but it also recommends that everyone over 60 be vaccinated. But I’ve never had chickenpox. Ergo, I can’t get shingles. So, should I get vaccinated or not? Seems like a pretty straightforward question to me, so why such contradictory advice from all quarters?
A: Chickenpox is an extremely contagious disease caused by the varicella zoster virus. It presents with a blister-like rash, itching, fatigue and fever. The rash appears first on the trunk and possibly on the face, moving outward. It spreads from infected individuals to others who have never had chickenpox, nor have they received a chickenpox vaccine. The condition can be spread via touching, breathing in virus particles, and through the air via coughing or squeezing.
According to the CDC, anyone who has not had chickenpox or has not received the vaccine can get the disease. Classic symptoms include he rash that will ultimately itch, fluid filled blisters, fatigue, headache, fever, and a loss of appetite. Individuals who have been vaccinated against chickenpox may still get the disease; however, symptoms are milder, there are fewer blisters, and a fever may or may not be present. Complications may include toxic shock syndrome, bone and joint infections, dehydration, pneumonia, and a great deal more.
WebMD indicates that while an individual may never have been diagnosed with chickenpox as a child, he or she may have contracted the virus and had minor symptoms without the classic rash. They went on to indicate that even if an individual was never infected, a person is still a candidate for Zostavix, the vaccine for individuals 60 years of age and older to help prevent shingles and decrease the risk shingles side effects. If you really want to know if you had chickenpox in the past, a blood test will confirm or rule out any doubt you may have.
Mayo clinic indicates Zostavax is not recommended if a person has ever had an allergic reaction to gelatin or other components in the vaccine, has a weakened immune system due to HIV/AIDs, or has/had another disease that affects the immune system, is receiving immune system suppressing drugs or treatment, has cancer that affects bone marrow or the lymphatic system, or is pregnant or attempting to get pregnant. There is no comment as to whether a person who never had chickenpox should receive the shingles vaccine.
In 2007 the Union Tribune in San Diego carried an article that even though an individual may not have had chickenpox, it may be good insurance to get the vaccine because as you age, you are a candidate for Zostavax. The injection would then protect an individual against a possible future outbreak of shingles.
In October 2006 the U.S. Centers for Disease Control and Prevention Advisory Committee on Immunization Practices voted to recommend the zoster vaccine be given to all adults age 60 and over, including those who do not recall having had chickenpox, since more than 90% of Americans ages 40 and older have had chickenpox.
All in all, the information available through numerous sources is a bit shaky and doesn’t specifically address the issue. The guidelines for individuals who should not have the vaccine are clear; however, there are no specific instructions for individuals who haven’t had chickenpox. Therefore, I recommend you speak with your physician to determine if a Zostavax injection is recommended or should be avoided in your case. It appears a physician’s word is more concrete than the minimal and perhaps outdated information available on the internet is.
